Ending Cervical Cancer

It’s one of the most preventable cancers in women.

By Craig DeSilva

Although there are some things we can do to help prevent certain types of cancer
– don’t smoke, exercise, eat a healthy diet – there are many who
succumb to the disease despite all their best efforts to lead a healthy lifestyle.
But when it comes to cervical cancer, there are actions women can take to prevent
the disease or detect it early.

“The survival rate for women with cervical cancer, if we catch it early, is
almost 100 percent,” says Michael Carney, M.D., medical director of the Kapi‘olani
Women’s Cancer Center and an HMSA participating physician. “Unlike a
lot of other cancers, cervical cancer takes a long time before it becomes a cancer.
So we have a lot of time to catch it.”

Genital human papillomavirus (HPV) is the most common sexually transmitted infection.
It can cause cells on the cervix to grow abnormally and develop into cancer. It’s
not unusual for women to develop HPV, since about 60 percent of them will contract
the virus sometime in their life. Although a woman’s immune system typically
allows the virus to remain dormant, it can survive for years in some women and eventually
become cancerous if not detected.

“When these cells don’t receive a message to stop, they keep growing,”
says Carney. “Then they get another signal to travel somewhere else. Basically,
it’s a mistake in the genes of the cell. It’s no different from any
other cancer.”

A Pap smear screening can detect HPV before it becomes cancerous. The Centers for
Disease Control and Prevention (CDC) recommends that women receive regular Pap smears
between the ages of 21 and 65, or within three years of the onset of sexual activity
(whichever comes first).

“Women who get screened for cervical cancer are not the ones who get the cancer
because we catch them early, even if they miss a year or two. It’s the women
who don’t get the screenings who are at risk,” Carney says.

Most of the women who are diagnosed with cervical cancer are over age 50. That’s
when women tend to stop seeing their gynecologist because they no longer are having
children and don’t need prenatal care or birth control pills. “That’s
when we lose touch with these patients,” he says. “At that point, the
[cancer] has spread. We want to catch it earlier.”

Before the Pap smear was introduced in 1941, cervical cancer was the number-one
cause of death for women in the U.S. Many of them died in their 30s. Pap smear screenings
have helped reduce the death rate by more than half. According to the CDC, six out
of 10 cervical cancer cases occur in women who have never received a Pap smear or
have not been tested in the past five years. About 90 percent of women whose cervical
cancer is detected by a Pap smear will survive.

“It’s an example of how early detection can reduce the rates of cancer,”
says Brenda Hernandez, a researcher at the University of Hawai‘i Cancer Research
Center. Hernandez is part of a team of researchers studying why some women are naturally
able to resist the virus more than others.

Gardasil and Cervarix, two HPV vaccines approved within the last few years, have
proven to be the most effective defense against cervical cancer. The vaccines are
recommended for girls ages 11 to 12 and may be given as early as age 9. The CDC
recommends women ages 13 to 26 receive the vaccines if they haven’t already
been vaccinated.

“It’s a real breakthrough in cervical cancer prevention,” says
Hernandez. “The HPV infection for most women occurs when they first become
sexually active in their late teens or early 20s. This vaccine is intended for women
prior to their becoming sexually active and exposed to HPV.”

The vaccines, however, are not intended to replace Pap smear tests because they
don’t protect women from all types of HPV. So doctors continue to stress the
importance of getting screened for cervical cancer at least every three years starting
at age 21 or within three years of onset of sexual activity. Pap smears and the
HPV vaccine are benefits of most HMSA health plans.

Island Scene Online is not intended to replace the advice of health care professionals.
Please consult your physician for your personal needs and before making any changes
in your lifestyle.